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MoscowMemphis

Moscow, Russia / Memphis, Tennessee

1998


Focus: Infection Control



The Partners

US Partners: Methodist Health Systems, Inc. — which includes St. Jude Children's Research Hospital, Methodist Hospital, and LeBonheur Children's Hospital — is a healthcare system based in Memphis,
Tennessee. It includes an operating hospital, health clinics, diagnostic and surgery centers, and home health agencies in West Tennessee and Mississippi. Methodist Health Systems, Inc. employs nearly 11,000
associates and operates more than 2,700 licensed beds; it is the twelfth largest privately owned hospital system in the United States.

Russian Partners: The Scientific Research Institute of Pediatric Hematology at Republican Children's Hospital of Moscow was founded in April 1991. It is Russia's leading research and clinical institution in the field of pediatric hematology, oncology, and immunology. The Institute's specialists were the first in Russia to start using the most
up-to-date clinical treatments for leukemia, anaplastic anemia, and primary immune deficiency, as well as the first to do bone marrow transplants. The Institute conducts numerous training courses and workshops at pediatric hospitals.

 



Partnership Objectives

The overall objective of the partnership was to improve the quality of
pediatric care, particularly for diseases of the blood, by implementing modern, evidence-based infection control and prevention standards and clinical practices.

To this end, partners:

Developed, implemented, and conducted ongoing evaluations of diagnostic techniques and treatment strategies for children with lymphoma, leukemia, and other diseases; and

Improved the quality and scope of targeted services, including blood product safety and the management of fevers and neutropenia.



Key Events and Achievements

 

Pediatric Hematology


In February 1998, two Russian physicians traveled to Memphis for a three-month internship at St. Jude Children's Research Hospital. They participated in the care of patients with leukemia, lymphoma, and solid tumors, as well as those undergoing bone marrow transplants. They also attended conferences, conducted primary research, and met
one-on-one with leading US and international experts. As a result of their advanced training, they were able to initiate many changes in clinical practice and mentor colleagues at the Institute.


In October 1998, the Advisory Board Foundation in Washington, DC, donated 40 vials of ATGAM and 500 vials of Amikacin worth $67,000 for pediatric cancer patients at the Institute for Pediatric Hematology.

Partners conducted an interactive videoconference on acute lymphoblastic leukemia in October 1998, which was attended by more than 100 US physicians and 10 NIS participants. Case studies were presented by partners on both sides. A similar event was conducted in December on the topic of infection management.


Partners facilitated the extension of a preliminary study of non-Hodgkin lymphoma in Russia and submitted a manuscript for publication.


Partners improved laboratory diagnostic procedures for evaluating patients with suspected acute leukemia, introducing the use of initial bone marrow smears and review of morphology and special stains.


Thanks to training they received through the partnership, the Russian physicians gained a better understanding of how to effectively manage infections in immuno-compromised children. Specifically, they implemented new institutional guidelines for the management of fever and neutropenia that closely parallel recommendations in AIHA’s Infection Manual.


Partners worked together to review how treatment plans for malignant conditions are selected. For acute leukemia, for example, this was based on both the subtype of leukemia diagnosed and on the clinical and biological risk factors. For those who presented with malignant lymphoma, the histologic and stage direct approach to management was extensively reviewed.


Although the management of allergenic/immunologic disorders in children was not a specific goal of the partnership, two of the fellows were able to spend an extensive amount of time in clinics that focus on these disorders where they learned about congenital immune deficiencies, as well as acquired allergic and/or immunologic disorders.

Principles pertaining to the management of infections in children with cancer are clearly pertinent in the management of children with immuno-deficiency disorders and infections.


In January 1998, USAID awarded the Moscow/Memphis partnership a limited short-term grant to enable them to build on previous activities and accomplishments through an intense series of professional exchanges targeting specific objectives.





Participating Institutions

 


Updated: March 20, 2009